Is Venous Stenosis Associated with Iron Deposition in the Brain? Preliminary Results of a Study of MR Venography and Susceptibility-Weighted Imaging (P05.124)

Abstract

Objective: To assess the value of MRV in analyzing deep brain, neck and chest venous systems in MS patients and controls. Background CCSVI is reported to be associated with MS. Controversy surrounds the frequency and pathogenic significance of this finding in MS. In addition, there is speculation that abnormalities in cerebral venous outflow may cause cerebral iron deposition in MS, which can be assessed on MRI using susceptibility-weighted imaging (SWI). Design/Methods: MRV and SWI were performed in 47 MS patients and controls (mean age 51.7 years ±9.0, 68% females) on a 3T Siemens Trio. All subjects received a 2-D time of flight intracranial MRV, contrast enhanced time resolved MRV of the upper chest, neck and head, and intracranial SWI. Two blinded neuroradiologists used a predefined scoring system to assess by consensus the presence of stenosis in the deep cerebral, jugular and azygous veins on MRV, as well as SWI abnormalities in the brain. Results: Six subjects had some areas not visualized, but were retained in the analysis. Overall 16 (34%) of subjects showed venous stenosis in one or more veins: 5 (10.6%) internal jugular (1 with >50% reduction), 4 (9.1%) azygous vein, 12 deep cerebral vein (25.5 %). SWI abnormalities were detected in 13 subjects (29.5%), with the majority (84.6%) localized in the supratentorial region. Four (25%) of the 16 subjects with venous stenosis showed SWI abnormalities. Conclusions: This preliminary study shows that MRV detects abnormalities in cranial and cervical veins. Although our dataset remains blinded to diagnosis, 34% of subjects had venous abnormalities. While SWI abnormalities suggestive of iron deposition were seen in a subset of subjects, there appeared to be no association between SWI and venous abnormalities. Our interim results do not support the hypothesis that iron deposition is related to venous stenosis. Supported by: National MS Society (RC 1004-A-5). Disclosure: Dr. Rae-Grant has received personal compensation for activities with Novartis, Biogen Idec and Teva Neurosciences as a speaker. Dr. Phillips has nothing to disclose. Dr. Jones has nothing to disclose. Dr. Diaconu has nothing to disclose. Dr. Ramesh has nothing to disclose. Dr. Fox has received personal compensation for activities with Avanir, Biogen Idec, EMD Serono, and Novartis. Dr. Fox has received research support from Biogen Idec and Genentech, Inc.